Ultrasound bi-rads 4

June 29, 2010 I had a mammography it was bi-rads 0, No spiculated mass or malignant calcification are identified.  The density seen behind the left nipple likely is residual fibroglandular tissue.  Ultrasound will be performed to further evaluate an possibility of cysts present there.  Coarse benign calcification are seen in the left brest.  No spiculated mass or microcalcification are identified.

Ultrasound report it was bi-rads 4 - On the left side, a dilated duct is identified and there appears to be a small nodule within the duct measuring 4mm in diameter.  The patient state have surgery on her left breast previously with bengin tumor as the result.  Perhaps papillomas were present previously.  Ultra-guided biopsy of the small nodule is recommended for further evaluation.  

The impression (Radiologist comment) Small 4 mm in dilated duct in 6"o'clock left periareolar regions perhaps a papilloma.  Suggest ultrasound guided biopsy for further evaluation.

I am 45 years of age, do not have biological children, had a hysterectomy at age 25, two lumpectomy one in my 20"s and the others in my 30's both benign.

My doctor told me that I had a 50/50 chance of being cancerous but the radiologist clerk said they think it is benign.    Reading all the information in regards to bi-rads 4 it is as high as 95% of being cancerous.

[japdip]

There is a range for BIRADS 4 assessments .... it's from 25% up to something less than the 95% you mention. Mammography and Sonography are used often together because both do not "see" the same things and not in the same way. I would advise you to follow the recommendation and have the biopsy of the suspicious nodule. As stated by the Radiologist this may well be a Papilloma but it is best to investigate to be sure as Papillomas can be either benign or malignant.  Regards ....

[bluebutterfly2222]

Japdip is correct. The range for malignant  RESULTS  from biopsy for BI-RADS 4 is around 25%-50%.

What you may have read is that for a radiologist to rate an image BI-RADS 4, s/he must believe there is a more than 2% but less than 95% CHANCE that it could be malignant.

Hope this helps.

Best wishes...

[Slove3904]

Hello I just got back my biopsy result and the Diagnosis is as follow:  Breast, let 6:00, Needle Biopsy:  Scant Fragments of adipose tissue and fibrovascular tissue with not breast tissue identified.

Noted:  "The material is fairly scant and breast tissue is identified.  The biopsy may not be representative of the lesion described as a nodule.  Clinical correlation with possible re-biopsy is suggested.  

My doctor tell me to come back in 6 month for retest...what does all this mean.  Please help.

[bluebutterfly2222]

Hi again,

The good news is that no cancer cells were found. The "bad" news is that the  pathologist's opinion was that the needle biopsy didn't get enough tissue to allow him/her to be certain that the samples  adequately represented the nodule in question. (In other words, it might have missed something.).

Therefore, the suggestion was to possibly consider doing a repeat biopsy.  (A core biopsy takes larger samples than a needle biopsy, and an excision removes the whole nodule.)

Your doctor told you to wait 6 months. You can go along with that, or request a repeat biopsy now, if you would feel more comfortable knowing for sure what it is.

Best wishes...

[Slove3904]

Thank you for your response, no I do not fill conferable I am going to see a specialist Friday to get a 2nd opinion.  I am so stressed, I can hardly function.

Thanks,

[bluebutterfly2222]

I am glad that you have an appt. scheduled with a specialist, and that it is not too far away.

Considering the high level of stress you are experiencing, I think you will feel much happier having a second opinion, or even another biopsy to be certain what is going on.

Best wishes,
bluebutterfly

[Slove3904]

Thank you very much for your support, I just spoke with the radiologist and he said that I should get another biopsy but I should wait for another week, due to by last biopsy was only two weeks ago.

[bluebutterfly2222]

I hope your second biopsy goes fine, and that the results are benign.
I know it would still be worth it to you, just to have the peace of mind.
And if, on the off chance, something should show up,
you'd know it's at the earliest possible time...

Regards,
bb

[Slove3904]

Thank you very much for responding to my post, it makes me fell better to know that someone on the other end knows what I am going through.  I had my 2nd biopsy done today and hopefully that I will get the result tomorrow...please keep me in your prayer.

[bluebutterfly2222]

I will certainly be keeping you in my thoughts and prayers while you wait for the path. report from your latest biopsy.

Please keep us posted...

warm regards,
bb

[Slove3904]

I just received my result back from my biopsy and it was benign...Thank you Jesus!!! However, I am still having pain in my breast, my doctor told me that I have Benign Fibrocystic Breast Disease I am wondering is that have to do with my pain.  

[bluebutterfly2222]

Soooo happy to hear about your B9 results!

Fibocystic Breast Disease certainly  causes  pain for many, many women, esp. at certain times during their menstrual cycles.

Some people get partial relief through eliminating caffeine (chocolate and other sources as well as coffee) or trying primrose oil. Some people also find that keeping sodium in the diet low, esp. premenstrually, also helps.   If you search the term, I'm sure you will find many other suggestions.  (Hint:Try one change  at a time, so that you will know what works, or doesn't work, for you.)

Best wishes...

[bluebutterfly2222]

p.s. Just checked back and noted that you have had a hysterectomy, so some of the above ideas may not apply to you.

On the other hand, several of my patients who have had hysterectomies, esp. at an early age, insist that they still experience PMS-type symptoms, as though they are still going through their cycles. even though they don't have a uterus or periods, so if that resonates with you at all, you might still give the ideas a try.

[katarina777]

That's what my sister says who had her uterus removed about two years ago. She still has her ovaries and she says everything is the same, like same PMS, just no bleeding. Kat